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FINDINGS 

Review of casework is the responsibility of the Division of Program Services. We have a computer program that selects cases at random each month that are to be reviewed by the Field Office Administrators. One case per counselor per month is reviewed. The results are entered into a database and reports can be generated as needed. A TRACKS (see below) meeting is held every other month and a report of the findings is prepared and sent to all staff.

Field Administrators review all eligibility Statements and Individual Plans for Employment for all new counselors in their first year of employment. These documents are initialed to show evidence of review. This is to insure that the new employees are knowledgeable and making sound judgement decisions.

Team Review to Advance Counselor Knowledge and Skills is a review process on active cases to insure quality in:

This process is both a learning and teaching tool for managers. It puts managers in the role of coach and trainer. TRACKS helps managers keep up to date on best practice Rehabilitation and gives them practical information to share with staff on good casework practices. We do not want case reviews to be perceived by staff as threatening, but as a means for all of us to actively seek continuous improvement. Managers involved as coaches can promote and develop counselor judgement.

This team is comprised of representatives from Central Office Division of Program Services, Field Administrators, and Counselors. Special staff may be asked to participate based on the nature of a particular case review. For instance when reviewing hearing impaired cases staff from the Deaf and Hard of Hearing Services were asked to participate.

The purpose of the Quality Assessment Team is to identify issues that need to be addressed through the TRACKS process and select appropriate cases for review. The team also revises the case review form as necessary for continuous improvement.

This team is made up of all Field Administrators. Representative counselors are also rotated through the TRACKS meetings. There are approximately 17 managers and 13 counselors who participate in each meeting. During the meeting the managers and counselors are broken into four separate teams so that there can be a comparison of the review results of all four teams.

1. One case per counselor is selected by the computer at random each month to be reviewed by the manager or a local review team. The review is done using a Performance Analysis form.
2. The results of these are sent monthly to a central office Rehabilitation Assistant who enters them into a database. District as well as statewide statistics can be generated from this database as needed.
3. A sampling of these reviewed cases are selected at random by the computer to be reviewed by the Quality Assessment Team. The Quality Assessment Team may choose to target certain areas such as: Most SD, Training, Substance Abuse, 28 closures, etc. to look at emerging trends.
4. Four of these cases are selected every other month for the statewide TRACKS meeting.

TRACKS Meeting Process:

1. All members of the Field Leadership Team and representative counselors from each district participate in this process. These individuals are broken into four teams to review the cases.
2. Each team will review and discuss all cases and come to a consensus on the review form.
3. Then they will come back with the large group and present their teams findings on each case.
4. The group as a whole identifies emerging trends, findings, and best practice, and makes recommendations on actions required.
5. Summary of findings is sent out to all staff. This document also includes the group’s recommendations and actions to be taken on each recommendation. Best practices that emerged from each review are also identified in the document.

How Managers Use the Process:

TRACKS

November 5-6, 2003

Frankfort, Kentucky

Case 1

Issue Identified:  Confusion on use of Person Centered Job Selection.

Question:  Is there an issue regarding this case that is not covered by regulation, policy, or best practice?

Answer:  We have a policy to cover this but it is not always being followed.

Recommendations: Further guidance on Person Centered Job Selection needs to be added to the Counselor Manual and on the Intranet.

Action Steps: Teresa Barney will make sure the new Supported Employment Guide Book is added to the Intranet.   Carol Estes and Allison Jessee are working on Supported Employment revisions to the Counselor Manual.  Supported Employment staff are available to provide additional training to field staff.   Managers should contact their Supported Employment representative to request additional training.

Case 2

Issue Identified:  This was a good homemaker case. The rehabilitation technology services provided and documentation made it a good case. A homemaker case can be legitimate but they hurt our standards and indicators.

Question:  Is there an issue regarding this case that is not covered by regulation, policy, or best practice?

Answer:  No.

Case 3

Issue Identified:  Use of wage checks for closure without documentation.

Question:  Is there an issue regarding this case that is not covered by regulation, policy, or best practice?

Answer:  No.  There is nothing wrong with using a wage check for closure as long as the case documentation draws a correlation between services and employment.

Recommendations:  Guidance will be developed on use of wage checks.

Action Steps: Managers group working on closure documentation will include guidance on appropriate use of wage check.

2^nd Issue Identified:  Case file does not contain documentation of an assessment.

Question:  Is there an issue regarding this case that is not covered by regulation, policy, or best practice?

Answer:  No. 

Recommendations:  Case review form should reflect that if the answer to IPE #3 is “no” then the answer to IPE#4 should be all no’s as well.

Action Steps: Robin will make the change on the case review form and send it out.

TRACKS
August 11-12, 2003
Lexington, Kentucky

  Recommendations:

1. Look at ways to bring consistency to casework.
2. Add process (selectively) including standard format.

Action Steps: 

The managers have decided that at their October meeting they will all bring examples of good casework.  This will include samples of good progress notes, plans, amendments, closures, etc., representing each step in the rehabilitation process.  They will share this information with each other and work toward arriving at a best practice format.  Based on this they will make specific recommendations regarding standard format requirements for documentation in the rehabilitation process in order to bring consistency to casework.

Questions for Clarification:

1. What are the requirements for documentation in a case?

Managers will be making specific recommendations regarding standard format requirements for documentation in the rehabilitation process.  For additional information please refer to the attached documents,” Requirements for Documentation in the Law” and “Documentation”. 

2. Is it appropriate to close a case with a wage record if we don’t talk with the client?

Yes, if there have been several documented attempts to contact the consumer. If the individual is working, documentation in the case record should show that the goal is appropriate and the consumer’s failure to respond is an indication that no further services are required.

3. If “no” documentation (#3 IPE) then are all the remaining answers “no”?

Yes- if there is no assessment then the other answers must be “no”.

4. Back dating of progress notes?

Staff should document case records within a reasonable length of time.  We cannot condone back dating progress notes.

5. How do you ever answer the questions about quality of placement?

A quality placement is consistent with the goal.  The individual is satisfied with their job and has wages and benefits to meet our indicators.

6. How do we define follow-up?

This depends on the context.  If it is within the 90 days after placement it would mean contact with the consumer and possibly employer to determine job satisfaction. Follow-up should occur through out the whole rehab process.

For example if the individual is a student a follow up would be done by meeting with the individual and obtaining a copy of grades.  If the individual is in therapy follow up would include obtaining copies of progress notes.

7. Is a wage record sufficient to close a 26 case?

See closure requirements in CFR 361.56.

In order to close a case there are four requirements:

1. Employment outcome is achieved.
2. Consistent with the individual’s choice.
3. Maintained 90 days.
4. Counselor and consumer agree that the outcome is satisfactory.

             If the counselor has documented numerous attempts to contact the individual and

             they are working and won’t respond, you may assume that the individual    

             considers the job satisfactory.

8. Expanded definition- what is “beyond routine”?

Beyond what is normally required for maintenance of the disability.

9. Are there exceptions to having a signed amendment at closure for goal change?

No.  The goal should be amended before closure.  If you “find” an individual working you should do the amendment and have it signed before closure.

10. Should we be going back and changing closures from 26 to 28’s?

Yes- if the case did not meet the requirements for a successful closure. (See CFR 361.56)

11. How do we handle cases that have pending legal issues?
12. Need to ask at initial interview about pending legal issues- should we be taking applications on these individuals?

The individual must be available to complete the assessment process or an application should not be taken. (See CFR 361.42)

TRACKS

April 2-3, 2003

SD Coding/Expanded Definitions

Primary Issue:  Lack of documentation at each step in the rehabilitation process.

Conclusion:  Managers recommend that specific guidance on documentation be included in the counselor manual.  Karen provided information regarding the regulations on documentation that she uses in SET training. (See attached document)  Karen and Robin will work on a manual revision.

Primary Issue:  The expanded definition on the eligibility statement and the services on the plan need to be directly related.

Conclusion:  Managers recommend that there be a prompt on the eligibility statement and IPE form that indicates this.  Karen and Robin will work on this.

Primary Issue: The word “Training” under expanded definition is misleading.

Conclusion:  Managers recommend a revision of the wording.  Karen and Robin will work on this.

Case 1: Daniel V.

Case 2:  Jacob

Case 3:  Carroll S.

TRACKS

January 13-14, 2003

Transition Cases

Primary Issue:

Financial need information- even if the services planned are not based on financial need, should you still get the information?

Conclusion:

It is best to get financial information at application or as early as possible.  Not collecting the information is permissible if you are providing services that are not based on financial need.  You will need to obtain financial information at any time services will be provided based on financial need.  If financial information is not on the DVR 2 when the case is reviewed and services planned were not based on economic need then N/A should be marked on the review form. (Financial Need Section, Question  #2)

Primary Issue:

When should the 90-day clock start for a high school student?

Conclusion:

 For any high school student the 90-day clock should never start prior to the person exiting school.

Case 1: April C.

Case 2:  Thomas M.

Case 3:  John R.

Case 4: Bradley C.

Team Review to Advance Counselor Knowledge and Skills

TRACKS

DVR Central Office

April 17,2002

Emerging Trend:

                             Eligibility Issues

                                    Lacking parent or guardian signature for minor

                                     under 18

                                    No verification of SSI/SSDI

                              Requirements of applicants prior to application

                              No assessment for vocational goal.

Findings:

Case #1

·        Not eligible- no verification of SSI eligibility.

·        Presumptive eligibility- functional limitations not indicated on eligibility worksheet.

·        CBWTP does not equal Supported Employment.

·        Eligible- but no verification of SSI eligibility.

·        Eligibility and plan done w/o evaluation phase. Plan too timely.

·        No parental signature for 17 year old.

·        Legality supercedes eligibility.

·        Job coach did not identify student needs- no informed choice.

·        No connection between IPE and IEP.

·        Would have been good trial work experience case. 

·        Can CBWTP be considered Trial Work?

Case #2

·        Lack of assessment or documentation that justifies the selection of an appropriate vocational goal.

·        Service planned and not provided- was amendment necessary?

·        Comparable benefits not indicated on plan.

·        Vocational goal not compatible with disability- accessibility to substances.

·        Good case.

·        Dependence Vs abuse.

·        Can we assign tasks to individuals before we take application?

·        No documentation of treatment.

Case #3

·        Good plan.

·        Good progress note to support goal

·        No SAR.  Why should consumer have to apply for financial aide when we know the program is short term and not eligible?

·        Tutoring provided with no amendment.

·        Expanded definition of "Comp care" needed more detail.

·        "Ongoing" for time frame on plan.  Needs beginning date.

Case #4

·        Did she need reasonable accommodations?

·        Is goal still appropriate post stroke?

·        Good case- looked at comparable benefits and outside support services.

Department Direction:

·        SSI/SSDI Verification: If an applicant asserts that they are eligible for social security benefits and are presumed eligible for services there must be an award letter or verification of eligibility in the case or the case is not eligible.  [361.42(3) (B) (ii)]

·        Presumptive Eligibility: In the case of presumptive eligibility for SSI/SSDI recipients it is best to complete the eligibility worksheet including the functional limitations and expanded definition.

·        Legal Age: If an applicant is under 18 years old and there is not a parent or guardian signature the case is illegal and therefore ineligible.  Legality supercedes eligibility.

·        If a service is planned and not provided an amendment is not necessary but there must be documentation in a progress note.

·        Issue of Abuse Vs Dependence: There is not a distinction in an abuse Vs dependence diagnosis for the purpose of determining eligibility.  Functional limitations must be taken into consideration in both diagnoses.  The work of the Alcohol/Substance committee has not been released yet.  The issue of abuse Vs dependence will be covered in the final draft.

·        Contract for tutors: The final draft regarding training issues has not been released yet, however it will include a section that states that an agreement must be signed with a tutor.

·        CBWTP as a trial work experience:  The purpose of a trial work experience is to determine eligibility for DVR services.  The purpose of the CBWTP is to determine the nature and scope of services once the person is determined eligible.  The CBWTP is an excellent resource for job coaches and possible job sites.  You won't be paying the job trainer to assist with these trial work experiences through CBWTP.  That should come out of your regular budget.  Don't forget that with the trial work experience you are required to write a plan, without a goal, and identify services for providing trial work experiences.  You are also required to document the process.  Please refer to the counselor's manual for further instructions on providing trial work experiences, including the issue of clear and convincing evidence to determine someone not eligible.

·        The CBWTP cannot be used to meet an expanded definition for MSD.  It is time limited and does not automatically imply that long term services are required.

·        Can we assign tasks to individuals before we accept the case?  We cannot refuse to take an application on someone or require that someone do certain things before we'll take an application on them. In accordance with the law [361.42(4)(ii)] "the applicant's completion of the application process for vocational rehabilitation services is sufficient evidence of the individual's intent to achieve an employment outcome, and NO ADDITIONAL DEMONSTRATION ON THE PART OF THE APPLICANT IS REQUIRED."  If they sign the DVR 2, then we are to assume that their intent is to work and they are committed to this end.  To single out a disability group would be discriminatory.  Once we take an application, then we can't ask them to do certain tasks before we determine eligibility.  We can ask for only that information which is necessary to determine eligibility.  Eligibility is based on functional limitations, a person's need for DVR and whether they can benefit in terms of employment.  Once we determine that they meet these criteria, and they are eligible for our services, then, as part of the plan, we can negotiate steps towards their rehabilitation. 

·        Requirement for SAR in short term training cases: This requirement is included in Sam's December 13,2001 Memorandum.  The primary reason for there being an SAR in all training cases is to insure consistency in the application of the financial means test to all consumers who are receiving assistance from the Department with training costs.

How to Use as Field Leaders:

·        Use the form to review cases but make both positive and constructive comments-don’t just circle yes or no without explanation.

·        Use comment sections on form to coach, relay your expertise, knowledge of resources not considered etc.

·        Reviewing cases is a teaching tool.  Review the case based solely on the documentation contained in the case.  Do not consider what should have been or what could have been.  Say “No” on the form when you need to.  

·        Cover this TRACKS summary in your next staff meeting.

·        Use this information when reviewing cases in the future.

·        Work one on one with counselors who are struggling, or who show trends or deficiencies in their casework.

·        Explain TRACKS process to staff and emphasize:

TRACKS does not talk about specific counselors, but instead TRACKS talks about ways to achieve consistent casework and to identify methods for provision of quality vocational services leading to the positive employment of Kentuckians with disabilities!

 Continuous Improvement!!!!!

TRACKS

DVR Central Office

February 6, 2002

Emerging Trend:         Documentation

                        Vocational Assessment

                                           Need for Amendments

Findings:

·        Lack of assessment or documentation that justifies the selection of an appropriate vocational goal.

·        Vocational goal not compatible with disability.

·        Good case.

·        No amendments for additional services.

·        Case documentation does not show that consumer requires VR services.

·        Vocational goal was not specific.  " Wal-Mart employee” is too vague for vocational goal.

·        Evidence did not support need for services provided.

·        No explanation for expanded definition.

·        No service to address limitations.

·        Excellent progress notes from job coach.

·        Case not eligible- did not require services.

·        Needed assessment.

·        Filling out eligibility checklist has become routine.

·        Goal amended on closure.

Recommendations from Field Administrators or Action Required:

Amendment statement on closure form is misleading to counselors and needs to be removed.   Karen Lawrence will make the revision.  Field Administrators will review regulations regarding amendments with counselors for clarification.  361.45 (6) (7).

Continued need for training on expanded definitions.   Field Administrators will determine local need and provide at their discretion.

Recommend to Senior Leadership Team and Human Resource Development Team the need for skill building training related to vocational assessment and documentation.  Sherri to make recommendation on behalf of the group.

Consideration needs to be given to the development of a form that documents the process used to determine vocational goal.  This would address both the documentation and vocational assessment issues.    A form of this type has been developed by a local field office and will be attached to this document for your review.   Field Administrators will recommend the use of this to the local staff at their own discretion.

Department Direction:

·        Expanded service on Eligibility Worksheet must be reflected on the IPE.  Carefully review the definition of an expanded service before you determine that it is applicable for your case.

·        Address limitations with services on IPE even if the service is purchased through a similar benefit.

·        Pull together information in the case.  The difference in eligibility and ineligibility can be a matter of vocational assessment and documentation.

·        Make sure progress notes show how you selected the vocational goal and why that goal was appropriate.  The only evidence of the provision of guidance and counseling is what you write in the progress notes.   From a reviewer perspective, if it is not written down it did not happen.

·        Be very specific in naming the vocational goal.  General job categories or names of companies are not acceptable.

·        Give careful consideration to the functional limitations checked on the eligibility checklist.   There must be documentation in the case as evidence of these limitations.

How to Use as Field Leaders:

·        Use the form to review cases but make both positive and constructive comments-don’t just circle yes or no without explanation.

·        Use comment sections on form to coach, relay your expertise, knowledge of resources not considered etc.

·        Reviewing cases is a teaching tool.  Review the case based solely on the documentation contained in the case.  Do not consider what should have been or what could have been.  Say “No” on the form when you need to.  

·        Cover this TRACKS summary in your next staff meeting.

·        Use this information when reviewing cases in the future.

·        Work one on one with counselors who are struggling, or who show trends or deficiencies in their casework.

·        Explain TRACKS process to staff and emphasize:

TRACKS does not talk about specific counselors, but instead TRACKS talks about ways to achieve consistent casework and to identify methods for provision of quality vocational services leading to the positive employment of Kentuckians with disabilities!

 Continuous Improvement!!!!!

Team Review to Advance Counselor Knowledge and Skills
TRACKS
DVR Central Office
November 15, 2001
Self-Employment

Emerging Trend: Documentation
Vocational Assessment
Need for Amendments

Findings:

	Lack of assessment or documentation that justifies the selection of an appropriate vocational goal.
	Vocational goal not compatible with disability.
	Good case.
	Inadequate documentation for use of excess income.
	No amendments for additional services.
	Case documentation does not show that consumer requires VR services.
	Other disabilities identified in medical information not listed as secondary or addressed.
	IPE signed before the local team approved the business plan.
	No signed application on file in the case.
	No documentation of the consideration of comparable benefits.
	Vocational goal was not specific. "Self-Employment" is too vague for vocational goal.
	Provider of services not listed on plan.
	No evidence of local team approval for business plan.
	Consumer working at application therefore self-employment not a good decision.
	Not sober long enough to be stable. (two months)
	Case closed too soon based on financial information in the case.

 

Recommendations from Field Administrators or Action Required:

Counselors need guidance on the documentation of excess income. This information is included in the Counselor Manual under "Economic need and Comparable Benefits." Field Administrators will determine local need and review this section of the Counselor Manual with their staff.

Best Practices:

	An IPE for a self-employment case should be written but not signed until the local team approves the Business Plan.
	If the IPE does not outline specific services related to the Business Plan then it should be amended after the plan is approved and the Counselor has negotiated services.
	The role of the Self-Employment Proposal Review Team is to evaluate the feasibility of the business plan. The specific planning, negotiation, and approval of expenditures is the responsibility of the counselor and management staff as required under agency policy.
	A good example of a statement under "provider" for self-employment plan: "Vocational Rehabilitation and Small Business Development Center to assist in development of business plan and establishment of home-based business. Specifics to be outlined in business plan. All Agency guidelines will be adhered to and Self-Employment Team must approve plan before services initiated."
	Under the IPE section of the Performance Analysis form the word "Timely" refers to the time between the determination of eligibility and the development of the plan. Timely is relative to each individual situation. In some cases the plan can even be written too soon, before all pertinent information is available.
	The case record must indicate all comparable benefits were considered. A CMS printout is acceptable for this documentation.
	A self-employment case should be closed when planned services are completed and the business shows definite signs of stability. Ideally, the revenues from the business venture should equal or exceed operating costs. The financial statement should show that the consumer is making enough money to cover long-term cost without external support. In most cases, this will require a minimum of one year in operation.
	Training on writing a business plan can be provided as part of the vocational assessment.

How to Use as Field Leaders:

	Use the form to review cases but make both positive and constructive comments-don’t just circle yes or no without explanation.
	Use comment sections on form to coach, relay your expertise, knowledge of resources not considered etc.
	Reviewing cases is a teaching tool. Review the case based solely on the documentation contained in the case. Do not consider what should have been or what could have been. Say "No" on the form when you need to.
	Cover this TRACKS summary in your next staff meeting.
	Use this information when reviewing cases in the future.
	Work one on one with counselors who are struggling, or who show trends or deficiencies in their casework.
	Explain TRACKS process to staff and emphasize:

TRACKS does not talk about specific counselors, but instead TRACKS talks about ways to achieve consistent casework and to identify methods for provision of quality vocational services leading to the positive employment of Kentuckians with disabilities!

Continuous Improvement!!!!!

 

 

Team Review to Advance Counselor Knowledge and Skills

TRACKS

DVR Central Office

September 19, 2001

Vehicle Modification

Emerging Trend: Documentation

Vocational Assessment

Findings:

	Lack of assessment for adequate services related to vehicle modification as well as for the selection of an appropriate vocational goal.
	Case not well documented to show that consumer requires VR services.
	General confusion regarding the five year vs. seven year life expectancy for vehicle modification. DVR 10 says five years. "Useful Life Expectancy for Transferable Items" says five years and state regulations say seven years. The state regulations are correct based on federal regulations.
	Lack of coordination between eligibility, IPE, and services provided.
	Vocational goal was not specific. "Medical field" is too vague for vocational goal.
	Timelines for date to achieve goal on plan not realistic.
	Lack of documentation for informed choice.
	Worked through plan too fast.
	Case not eligible due to lack of documentation and vocational assessment.
	Functional limitations not documented.
	The kind of job search needed did not meet the expanded definition.
	Rehabilitation Technology not carried forward from eligibility worksheet to IPE.
	Excellent documentation of MSD.
	Plan written by consumer had a lot of problems.
	CMS screens not in case.
	Service of "Rehabilitation Technology" on plan is not specific enough.
	DVR paid for lots of services not listed on the plan.
	Counselors don’t have much experience with consumers writing their own plan.
	Provider of vehicle modification not listed on plan.

Recommendations from Field Administrators or Action Required:

The DVR 10 and the form "Useful Life Expectancy for Transferable Items" will be changed to be compatible with the administrative regulations in regard to the seven-year time frame. Wade and Dave will assure that the changes are made and then Sherri will notify the managers to clarify this issue with staff. Dave will generate a computer run on past cases given a five-year date and Kathy, Sherri, and Wade will study the issue to determine if these cases should be notified.

 

Best Practices:

	Counselors should be providing guidance and counseling to help consumer’s plan for future modifications rather than indicating that they can come back in seven years for a second modification.
	It is never appropriate to close a high school student as achieving a successful employment outcome while the consumer is still in high school.
	The Rehabilitation Technology provider should be listed on the IPE. If that information is unknown at the time of the plan, "to be determined" can be indicated and the plan amended later.
	It is best practice to make an eligibility decision within 60 days. Anything exceeding 60 days, including 61 or 62 days requires a waiver.
	Be very specific in naming the vocational goal. General job categories are not acceptable.
	Carefully review the definition of an expanded service before you determine that it is applicable for the case. Expanded services on the Eligibility Worksheet must be reflected on the IPE and thoroughly explained on the eligibility worksheet.
	Pull together the information in the case. The case will be reviewed not based on what could or should have been but what actually is documented in the case.
	Good documentation of functional limitations can make the difference in the determination of eligibility.
	Make sure your progress notes show how you selected the vocational goal and why it was appropriate. The only evidence of the provision of guidance and counseling is what you write in the progress notes. From a reviewer perspective, if it is not written down it did not happen. Document---Document---Document!
	It is often necessary to do further vocational assessment in order to provide quality guidance and counseling and insure that the choice is informed and the vocational goal is realistic.
	It is best practice to keep the copies of the CMS screens in the case.
	If the consumer chooses to write their own plan refer to agency document "Individualized Plan for Employment Options and Instructions" in order to provide your consumer with the best guidance. It is ultimately the counselor’s responsibility to review the plan to insure it contains all required information. Both parties must mutually agree upon and sign the plan.
	It is best practice to list vehicle modification, driver’s evaluation, and drivers training as separate services.

How to Use as Field Leaders:

	Use the form to review cases but make both positive and constructive comments-don’t just circle yes or no without explanation.
	Use comment sections on form to coach, relay your expertise, knowledge of resources not considered etc.
	Reviewing cases is a teaching tool. Review the case based solely on the documentation contained in the case. Do not consider what should have been or what could have been. Say "No" on the form when you need to.
	Cover this TRACKS summary in your next staff meeting.
	Use this information when reviewing cases in the future.
	Work one on one with counselors who are struggling, or who show trends or deficiencies in their casework.
	Explain TRACKS process to staff and emphasize:

TRACKS does not talk about specific counselors, but instead TRACKS talks about ways to achieve consistent casework and to identify methods for provision of quality vocational services leading to the positive employment of Kentuckians with disabilities! Continuous Improvement!!!!!

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Team Review to Advance Counselor Knowledge and Skills

TRACKS

DVR Central Office

July 12, 2001

Supported Employment

 

Emerging Trend: Providers training needed

Better Documentation Needed from Providers/ Counselors

Findings:

	No documentation or insufficient documentation supporting the payment for person-centered job selection services (vocational profile).
	Little documentation to justify vocational goal.
	Further vocational assessment needed for planning services other than Supported Employment.
	Lack of documentation of guidance and counseling.
	No verification of SSI/SSDI status in the case.
	Plan written prematurely. (prior to receipt of findings from the person-centered job selection)
	A few counselors do their own "vocational profile" which they send to the supported employment provider to use in planning for job development.
	Overall good case with good documentation.
	Plan should address all limitations identified on the eligibility statement.
	Describing the extended services on the plan as "long term support" is not adequate and needs to include specific services.
	Number of hours to be worked not addressed on plan or in profile.
	Numerous provider documentation errors.

Recommendations from Field Administrators or Action Required:

	There is a need to revise the training for the Supported Employment providers. The Supported Employment Branch staff and Claudia Ernharth from the Human Development Institute at the University of KY are in the process of working on the core content of this training. Specific attention has been given to the need for Providers to improve their documentation and reports. Training components have been added to the Core training which they hope will assist in better progress notes, person-centered job selection reports, job development service description, and general progress reports. All suggestions from staff are welcome.
	A revision needs to be made on the IPE in reference to the description of an extended service so that staff are reminded that routinely writing in "long term support" is not adequate. Karen Lawrence will work with the IPE Team to make the revision.
	Federal regulation 361.46(b) outlines the supported employment requirements in the content of the IPE. Field Administrators will determine local need and review this section of the law with their staff. The Supported Employment Branch staff are available to assist with any additional training needed by the Field.

Best Practices:

	Which expanded definition should be used for Supported Employment- job placement or training? Either one can be used and the case would be put in status 18.
	Even when there are other evaluation reports in the case file, it is best practice to authorize for person-centered job selection services so that the supported employment provider can become familiar with the person and help plan for job development activities.
	It is best practice to wait for the vocational profile before selecting the vocational goal and writing the plan. This sometimes means you have to encourage the provider to give you the documentation. It is okay to question the recommendations/findings in the documentation if you are not in agreement, or to ask for additional information if you feel the documentation is inadequate. Best practice would be to have a meeting where all stakeholders, including the consumer and family, are present to go over the recommendations.
	Best practice to put the case in status 10 for person-centered planning.
	Trial Work experience can be used to answer the "benefit" question or you can use Supported Employment to do this. Person centered job selection and job development may be substituted for trial work experience.
	Best practice to indicate the number of hours the consumer is expected to work on the plan.
	It is best practice to select an expanded definition on the eligibility statement of an SSI/SSDI eligible case. This helps the counselor determine the necessary services required on the IPE.
	The outcome fee for Supported Employment is $3,000 and may be paid after 60 days, unlike the outcome fee for CRP’s which is $3,350 and is paid after 90 days. The Supported Employment Outcome fee is less because there are separate hourly fees for person-centered job selection and job development. A supported employment case must be open for an additional 30 days before closure so that the long-term support services can be monitored and assured to be in place before the case is closed. District 10 is piloting another outcome based fee system currently being considered for statewide use.

 

How to Use as Field Leaders:

	Use the form to review cases but make both positive and constructive comments-don’t just circle yes or no without explanation.
	Use comment sections on form to coach, relay your expertise, knowledge of resources not considered etc.
	Reviewing cases is a teaching tool. Review the case based solely on the documentation contained in the case. Do not consider what should have been or what could have been. Say "No" on the form when you need to.
	Cover this TRACKS summary in your next staff meeting.
	Use this information when reviewing cases in the future.
	Work one on one with counselors who are struggling, or who show trends or deficiencies in their casework.
	Explain TRACKS process to staff and emphasize:

TRACKS does not talk about specific counselors, but instead TRACKS talks about ways to achieve consistent casework and to identify methods for provision of quality vocational services leading to the positive employment of Kentuckians with disabilities! Continuous Improvement!!!!!

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Team Review to Advance Counselor Knowledge and Skills

TRACKS

DVR Central Office

April 24, 2001

 

Emerging Trend: General Eligibility of Substance Abuse Cases

Purchase of Job Placement Services

Expanded Definitions

Vocational Assessment

Findings:

	There is confusion on eligibility issues and best practice for persons with substance abuse.
	There are cases where training plans are written when "work first" would be a more realistic goal.
	In several cases eligibility was based on inadequate existing information when further evaluation needed to be done.
	No documentation to justify vocational goal.
	Concerns about "needing" the services of Vocational Rehabilitation.
	No evidence to back up limitations on eligibility.
	Decisions well documented in excellent progress notes.
	IPE question #4 on the form does not correspond with the new IPE.
	Choices clearly outlined.
	There is confusion on the use of expanded definitions and their meanings.
	Further vocational assessment needed for planning purposes.
	Good documentation of guidance and counseling.
	More cost effective to use DVR staff for job placement services.
	Questions regarding the need to complete the rest of eligibility form in cases of SSI/SSDI presumptive eligibility.
	Old forms are still being used in some cases.
	Vocational evaluation was done in lieu of trial work experience.

Recommendations from Field Administrators or Action Required:

	Recommend that the Field Leadership Team take a look at the current guidance in the manual on Substance Abuse/Dependency during their next retreat and determine if this guidance needs to be revised or if it is good best practice guidance and staff need to be trained accordingly. Don Hiatt will present the policy in the meeting and facilitate discussion for manager’s recommendations.
	Recommend continued emphasis with staff on identifying transferable skills and looking at "work first" as an option. Field Administrators will provide guidance to staff. Karen Lawrence is available to provide Assessment Training (done at March Conference) to field offices upon request.
	Refresher training on diagnostics. Although the law specifies the use of existing information in determining eligibility it clearly supports assessment for determining eligibility and vocational rehabilitation needs as appropriate in each case. Field Office managers will review the applicable sections of the law with staff. Suggested sections to discuss include: 361.42, 361.45 (b)(1), and 361.48 a and b.
	Recommend that the Quality Assessment Team review the performance analysis form and update for changes so that it corresponds with the new IPE. Robin will work with the Quality Assessment Team to implement these changes.
	Refresher training on the expanded definitions. Field Administrators will determine local need and do at their discretion. This topic will also be addressed in future plans for continuous improvement training.
	Forms need to be dated. Robin talked to Mary Ann Evans and all forms are dated. However, not all forms have a date on the name of the form, which can cause confusion on the menu. All new forms in the future will have a date on the name. Field Administrators will remind staff that they have to delete their old forms to keep their files current.
	In light of the comments in relation to the purchase of job placement services and the questions surrounding the new service fee memo addressing the same issue it is recommended that the counselor manual section on Job Placement be reviewed for updates to insure that staff have good best practice guidance. Robin and Mindy will work on this.

Best Practices:

	In the case of presumptive eligibility for SSI/SSDI recipients it is best practice to complete the eligibility form including the functional limitations and expanded definition.
	Best practice is to determine a viable goal and what services are necessary to attain that goal. As part of the assessment process it is wise to consider a work experience as one tool to examine an individuals transferable skills and employment options before entering into a training program. The objective is not to deny an individual access to training, but to assess the need for training and the ability of that individual to participate and succeed in such an endeavor. A work experience is a valuable means of determining the individual’s motivation, stability, and commitment.
	Don’t confuse the existing information you use to determine eligibility with the assessment information you need to develop an IPE. Although existing information to determine eligibility is appropriate, it is often necessary to do further vocational assessment in order to provide quality guidance and counseling and insure that the choice is informed and the vocational goal is realistic.
	Carefully review the definition of an expanded service before you determine that it is applicable for the case. Expanded services on the Eligibility Worksheet must be reflected on the IPE.

 

How to Use as Field Leaders:

	Use the form to review cases but make both positive and constructive comments-don’t just circle yes or no without explanation.
	Use comment sections on form to coach, relay your expertise, knowledge of resources not considered etc.
	Reviewing cases is a teaching tool. Review the case based solely on the documentation contained in the case. Do not consider what should have been or what could have been. Say "No" on the form when you need to.
	Cover this TRACKS summary in your next staff meeting.
	Use this information when reviewing cases in the future.
	Work one on one with counselors who are struggling, or who show trends or deficiencies in their casework.
	Explain TRACKS process to staff and emphasize:

TRACKS does not talk about specific counselors, but instead TRACKS talks about ways to achieve consistent casework and to identify methods for provision of quality vocational services leading to the positive employment of Kentuckians with disabilities! Continuous Improvement!!!!!

 

 

 

Team Review to Advance Counselor Knowledge and Skills

 

TRACKS

DVR Central Office

February 14, 2001

 

Focus of Review: School-to-Work Transition

Emerging Trend: The current programs are more diverse than the original model. There is a need for clarification of roles and additional training.

 

Findings:

 

	Assessment was appropriate but training may not have been necessary.
	In the current system it is difficult for counselors to pull consumer out after evaluation if they feel that training is not appropriate.
	Counselors are left out of the decision process.
	Assessment and vocational goal exploration is an important up front component of these cases.
	ARC is not making the referrals.
	Job coaches appear to run programs.
	Contracts often not followed.
	LD diagnosis being served in these programs.
	There appears to be a lack of understanding on the part of all parties as to the current procedures for these cases.
	Supported employment is being used in conjunction with CBWTP.
	Students go through the community- based program and then they still need supported employment. There is a fine line between the programs.
	There are concerns about the programs closing down during the summer.
	Well- trained job coaches seem to be the key to successful programs.
	Many vendors will not stop evaluation even when they see there is no potential for work.

Recommendations from Field Administrators or Action Required:

 

Recommend that CBWTP Team continue to work with the schools and VR staff to streamline processes, insure open communication, and reinforce following recommended procedures. Sandy Conkin will continue to work toward these goals with the Department of Education and the UK Interdisciplinary Human Development Institute (IHDI). Joint training will be provided to all appropriate school and VR staff beginning in the fall of 2001.

 

More emphasis needs to be put on serving students with most significant disabilities. Sandy Conkin will insure that this is incorporated into the above training.

 

Best Practices:

 

	When the ARC makes the referral and the applicant advises you they do not want to work you may still make the decision to not take the application.
	Students in CBWTP can be SD or MSD.
	If the student doesn’t need a job coach on site (they just get dropped off) then they don’t need the community-based program.
	The ARC should make referrals as they direct the students curriculum program.

How to Use as Field Leaders:

 

	Use the form to review cases but make both positive and constructive comments-don’t just circle yes or no without explanation.
	Use comment sections on form to coach, relay your expertise, knowledge of resources not considered etc.
	Reviewing cases is a teaching tool. Review the case based solely on the documentation contained in the case. Do not consider what should have been or what could have been. Say "No" on the form when you need to.
	Cover this TRACKS summary in your next staff meeting.
	Use this information when reviewing cases in the future.
	Work one on one with counselors who are struggling, or who show trends or deficiencies in their casework.
	Explain TRACKS process to staff and emphasize:

TRACKS does not talk about specific counselors, but instead TRACKS talks about ways to achieve consistent casework and to identify methods for provision of quality vocational services leading to the positive employment of Kentuckians with disabilities! Continuous Improvement!!!!!

 

 

 

 

Team Review to Advance Counselor Knowledge and Skills

TRACKS

DVR Central Office

November 9, 2000

 

Focus of Review: Hearing Impairments

Emerging Trend: Documentation

Findings:

	There was not ample documentation for eligibility, vocational goal, or service provision.
	There is a lack of assessment for vocational planning and goal exploration.
	The timely transfer of the case to a communication specialist is very important.
	There was a big gap between the time the case was accepted and when the IPE was written.
	Good financial negotiation.
	Services provided to family members were found to not be appropriate.
	"Mobility" and "work tolerance" were checked as functional limitations without back up in case records.
	Annual review was not marked as such.
	There were technical problems on priority categories.
	No amendments were done for additional services.
	There is confusion on the use of expanded definitions and their meanings.
	The consumer did not require services and was therefore not eligible
	Needed services not provided.
	Expanded definition not addressed in IPE.

 

Recommendations from Field Administrators or Action Required:

Recommend that continued emphasis be put on the transfer of hard of hearing cases to Communication Specialists. Field Administrators will reinforce with staff the importance of transferring these cases to insure quality service provision.

Recommend that staff be reminded of the importance of tying a case together through documentation in progress notes. Field Administrators will coach staff on a local level.

Refresher training on the expanded definitions. Field Administrators will determine local need and do at their discretion.

 

Best Practices:

	Document---Document---Document! ! Pull together the information in the case.
	Expanded service on Eligibility Worksheet must be reflected on IPE.
	The functional limitations identified on the eligibility statement should be addressed in the IPE.
	Guard against a single service; consider if the consumer only needs DVR monies, not our expertise.
	Maintaining employment is a viable VR service. When working with this kind of case get information from consumers about problems on the job. Also ask for permission to talk to employers about problems. An employer will often mention additional communication problems that need to be addressed.
	Consider the need for purchasing technology beyond the hearing aid. Often consumers do not realize the need for additional technology until after the "honeymoon" with the hearing aid wears off. Then they realize that hearing aids do not solve all their communication problems. It is important to follow-up with consumers to determine the need for additional technology.
	Hearing aids are considered to be Rehabilitation Technology even though counselors pay for them out of their own budgets. There is no financial need for Rehabilitation Technology, including hearing aids. Hearing aids are now paid for using Rehabilitation Technology Expenditure Codes.
	Follow-ups after you have provided the service. This is important in all cases but particularly so in hard of hearing cases when hearing aids and /or equipment have been purchased.
	Transfer hard of hearing cases to Communication Specialists.
	If one of your reviewed cases comes back with an area that needs improvement make the necessary changes to fix the case if possible.

How to Use as Field Leaders:

	Use the form to review cases but make both positive and constructive comments-don’t just circle yes or no without explanation.
	Use comment sections on form to coach, relay your expertise, knowledge of resources not considered etc.
	Reviewing cases is a teaching tool. Review the case based solely on the documentation contained in the case. Do not consider what should have been or what could have been. Say "No" on the form when you need to.
	Cover this TRACKS summary in your next staff meeting.
	Use this information when reviewing cases in the future.
	Work one on one with counselors who are struggling, or who show trends or deficiencies in their casework.
	Explain TRACKS process to staff and emphasize:

TRACKS does not talk about specific counselors, but instead TRACKS talks about ways to achieve consistent casework and to identify methods for provision of quality vocational services leading to the positive employment of Kentuckians with disabilities! Continuous Improvement!!!!!

 

 

 

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Team Review to Advance Counselor Knowledge and Skills

TRACKS

Holiday Inn Capital Plaza

August 30, 2000

Emerging Trend: Expanded Definitions

Vocational Goal

Documentation

Findings:

	There is confusion on the use of expanded definitions and their meanings.
	There is a lack of assessment for vocational planning and goal exploration.
	There was not documentation to show how the vocational goal was selected, why it was appropriate, or the provision of guidance and counseling.
	Good use of existing information.
	College level training was selected without vocational assessment or justification.
	There was very little difference in the findings of Counselors and Managers in reviewing these cases.

Recommendations from Field Administrators or Action Required:

	Refresher training on the expanded definitions. Field Administrators will determine local need and do at their discretion.
	The issues of problems related to limited vocational assessment and the selection of an appropriate vocational goal have risen in previous TRACKS. Recommendations have been made to Senior Leadership Team and the Human Resource Development Team on the need for skill building training related to vocational assessment, vocational goal selection, and guidance and counseling. Field Administrators will continue to coach staff on a local level.
	Recommend that staff be reminded of the importance of tying a case together through documentation in progress notes. Field Administrators will coach staff on a local level.

Best Practices:

	Make sure your progress notes show how you selected the vocational goal and why that goal was appropriate. The only evidence of the provision of guidance and counseling is what you write in the progress notes. From a reviewer perspective, if it is not written down it did not happen. Document---Document---Document!
	Make sure you get a complete work history and complete financial information when you take the application. This information will be very beneficial to you later as you develop the case.
	Disability does not equal eligibility.
	Carefully review the definition of an expanded service before you determine that it is applicable for your case. Expanded services on the Eligibility Worksheet must be reflected on the IPE.

We should evaluate the appropriateness of those we are sending to college through vocational assessment.

 

How to Use as Field Leaders:

	Use the form to review cases but make both positive and constructive comments-don’t just circle yes or no without explanation.
	Use the comment sections on the form to coach, relay your expertise, knowledge of resources not considered, etc.
	Cover this TRACKS summary in your next staff meeting.
	Use this information when reviewing cases in the future.
	Work one on one with counselors who are struggling, or who show trends or deficiencies in their casework.
	Explain TRACKS process to staff and emphasize:

TRACKS does not talk about specific counselors, but instead TRACKS talks about ways to achieve consistent casework and to identify methods for provision of quality vocational services leading to the positive employment of Kentuckians with disabilities!!!!!!!!!

Continuous Improvement!!!!!

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Team Review to Advance Counselor Knowledge and Skills

TRACKS

Salato Center

April 11, 2000

 

 

Emerging Trend: General Eligibility of Drug and Alcohol Cases

Use of Work Adjustment and Supported Employment

Training First

Findings:

	There is confusion on eligibility issues and best practice for persons with substance abuse.
	There seem to be many cases where training plans are written when "work first" would have been a more realistic goal.
	Counselors seem to continue to feel they can’t say NO due to the choice provision in the law.
	There is a lack of assessment for vocational planning and goal exploration.
	Work Adjustment and Supported Employment are being provided in the same cases. ( sometimes at CDPCRC)

Recommendations from Field Administrators or Action Required:

	Recommend to Senior Leadership Team that we establish a policy for best practice in relation to eligibility for substance abuse cases. Training should be provided and guidance placed in the counselor manual. Sherri to make recommendations on behalf of the group.
	Issue of choice has consistently risen in all TRACKS meetings and is being addressed in future training. Field Administrators will work with staff on clarification and understanding of the responsibility they have in the provision of informed choice.
	Recommend continued emphasis with staff on identifying transferable skills and looking at "work first" as an option. Field Administrators will provide guidance to staff.
	Issues of problems related to limited vocational assessment and the selection of an appropriate vocational goal have risen in previous TRACKS. Recommendations have been made to Senior Leadership Team and the Human Resource Development Team on the need for skill building training related to vocational assessment, vocational goal selection, and guidance and counseling. Field Administrators will continue to coach staff on a local level.
	Recommend that staff be given some best practice guidance on the appropriate use of Work Adjustment and Supported Employment in the same case. Robin will ask Carol Estes for her guidance on this issue.

 

Best Practices:

	Think, "WORK FIRST".
	Don’t confuse the existing information you use to determine eligibility with the assessment information you need to develop an IPE. Although existing information to determine eligibility is appropriate, it is often necessary to do further vocational assessment in order to provide quality guidance and counseling and insure that the choice is informed and the vocational goal is realistic.
	Don’t accept a poor psychological evaluation. You are the customer!

 

How to Use as Field Leaders:

	Use the form to review cases but make both positive and constructive comments-don’t just circle yes or no without explanation.
	Use the comment sections on the form to coach, relay your expertise, knowledge of resources not considered, etc.
	Cover this TRACKS summary in your next staff meeting.
	Use this information when reviewing cases in the future.
	Work one on one with counselors who are struggling, or who show trends or deficiencies in their casework.
	Explain TRACKS process to staff and emphasize:

TRACKS does not talk about specific counselors, but instead TRACKS talks about ways to achieve consistent casework and to identify methods for provision of quality vocational services leading to the positive employment of Kentuckians with disabilities!!!!!!!!!

Continuous Improvement!!!!!

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TRACKS Meeting

Thursday, February 17, 2000

DVR Central Office

Frankfort, KY

 

FINDINGS

	There appears to be the need for clarification in several areas related to the eligibility worksheet. These include: expanded definitions, interchange of primary and secondary disabilities, addressing secondary disabilities, and Step 3 on the eligibility form.
	Lack of consistency in negotiation practices statewide. In one instance an individual was given less tuition assistance than was allowed based on our formula. In another case there was a very large excess income and books were still provided.
	Good use of rehabilitation technology.
	Counselors seem to feel that they cannot say "no" to inappropriate vocational goals due to the Choice provision in the law.
	Financial assessment on the DVR-2 was not filled out in all the cases.
	Good documentation on comparable benefits.
	Good Futures planning.
	Vocational goal was in conflict with the limitations of the disability.
	Questionable content and language in form letters to consumers and school staff (Example: "crisis" and "rehabilitation scholarship")

RECOMMENDATIONS

Refresher training on the eligibility worksheet to include the following issues: 1. Expanded definitions and their relation to the disability. 2. Multiple disabilities – how to identify which is primary and which is secondary. 3. Clarification of Step 3 on the eligibility worksheet. 4. Tying secondary disability to functional limitations and services on the IPE.

Field Administrators will determine local need and do at their discretion.

Policy on the provision of books needs to be looked at further and guidance sent to the field.

Field Administrators will discuss this issue further at their next team meeting and make recommendations.

	Issue of choice has consistently risen in all TRACKS meetings and is being addressed in future trainings.
	Don will find the memo addressing financial need on the back of the DVR-2 and reissue.
	Recommend that form letters should be reviewed for appropriateness of content and language. Field Administrators will ask staff to review form letters and offer technical assistance.
	Recommend more training on Best Practice issues. For example, since the national trend is "work first", we need to work with the staff on identifying transferable skills. Sherri to make recommendation on behalf of the group.

BEST PRACTICE

	In an IPE for supported employment, the number of hours the individual wishes to achieve must be specified. (See counselor manual, page 17-4.)
	Financial needs assessment needs to be filled out on the back of the DVR-2 even if services are not subject to financial need.
	Use of the word "scholarship" when referring to DVR’s financial assistance for a student is misleading and is not the best practice.

The following notes were taken directly off the flip chart and may be helpful as a coaching tool:

CASE #1 – Marcus Welby

	ARC did not agree with teachers.
	Not eligible for 504 services.
	Rehab "scholarship" announcement (local call)
	Eligibility and SD based on ADHD – vocational goal not compatible with this.
	Question of "stretching" SD.
	Questionable letter to school staff – form letters should be reviewed. They need to be careful on language (Example: crisis).
	No service related to second disability.
	No functional limitations for secondary disability.
	No financial aid report.
	Large excess income. Books provided. Negotiation?
	Good parental form.
	Do we need to look at money spent on books? Do we need to change our policy on book provision?
	More training needed on Best Practice issues. For example: Looking at transferable skills. National trend: Work First.
	Informed choice is still an issue.

CASE #2 – June Morgan

	Expanded definitions – not all related to the disability.
	Good form for choices.
	Less tuition than entitled to based on formula – questioned statewide consistency. We need to look at this.
	Good use of technology.
	Concern about primary and secondary may interchange.
	Good case.
	Issue of counselors comfort level for saying "no" to consumer’s choice of vocational goal if inappropriate.

CASE #3 – Mary Richards

	Need number of hours to be specified in IPE for supported employment (page 17-4 in manual).
	Confusion on Step 3 on eligibility form.
	Financial assessment needed to be filled out on DVR-2 even if services are not subject to financial need. (Don will find the memo.)
	Good documentation on comparable benefits.
	Good Futures planning.
	Case ready to be closed.

 

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Team Review to Advance Counselor Knowledge and Skills

TRACKS

Georgetown College Conference and Training Center

November 4, 1999

 

 

Emerging Trend: SD/MSD Coding

Limitations vs. Attendant Factors

General Eligibility of Drug and Alcohol Cases

Findings:

	There appears to be a lack of consistency in counselor judgement in the determination of SD/MSD coding.
	Functional limitations listed were sometimes the result of attendant factors rather than the disability.
	There is some confusion on the general eligibility guidelines for persons with chemical dependency diagnosis.
	Tuition assistance is a common service for those with chemical dependency.
	Appropriate vocational goal selection is still an issue.

Recommendations from Field Administrators or Action Required:

	Recommend training on best practice related to working with individuals with substance abuse-Sherri to make recommendations on behalf of the group.
	Further clarification and guidance needed on psychological diagnosis that contain "by history, in remission, provisional and R/O".-Robin to work with Patty Reynolds, Mental Health Specialist. Clarification will be sent to field staff along with new DSM IV Crosswalk.
	Investigate the use of the same disability code for primary and secondary disability in the Case Management System. Robin will meet with Mary Ann on the issue.
	The eligibility worksheet used in case one had some very useful prompts for those who do these forms by hand. It would be helpful to have this available for those who would like to use it. Robin will ask Janet Pearson for a copy and send it to the Field Administrators for distribution.
	Refresher training on eligibility worksheet to include issues related to attendant factors, expanded definitions, and SD/MSD coding. Field Administrators will determine local need and do at their discretion.

Best Practices:

	Try to take a positive approach when negotiating services with a consumer. Although it is tempting to say "we don’t have enough money", it’s best to point to the financial statements in the Consumer Guide, use your negotiation skills, and seek all comparable benefits available.
	Remember when providing tuition assistance at a private or out of state institution based on the sliding scale, you must multiply percentage times the tuition of the highest state-supported institution in Kentucky offering similar vocational preparation.
	Explore secondary or other identified disabilities.
	A psychological evaluation should not be scheduled unless a problem is reported or observed. Use existing information.
	Good documentation of functional limitations can make the difference in the determination of eligibility.
	Disability does not equal eligibility.
	Functional limitations = vocational impact.
	Attendant factors = life circumstance.
	Remember participation in AA/NA is strongly encouraged but it can not be used to meet the expanded definition of mental restoration.

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Team Review to Advance Counselor Knowledge and Skills

TRACKS

Lake Cumberland State Park

August 12 and 13, 1999

 

 

Emerging Trend: Vocational Goal

Findings:

	Vocational goal was in conflict with the limitations of the disability
	There was not ample documentation to show how vocational goal was decided upon
	Vocational goal was not feasible in light of job requirements i.e. drug testing, criminal record, etc.
	Counselors seem to feel that they can’t say NO because of the choice provision in the law

Recommendations from Field Administrators or Action Required:

	Recommend to Senior Leadership Team and the Human Resource Development Team the need for skill building training related to vocational goal; guidance and counseling; and choice-Sherri to make recommendation on behalf of group.
	Recommend training on best practice related to working with individuals with substance abuse-Sherri to make recommendations on behalf of the group.
	Revisit crosswalk of DSM-IV and RSA codes-Robin to work with Patty Reynolds, Mental Health Specialist.
	Check guidelines on usage of excess income-confusion exists-Don will review guidelines and send a memo or reminder to field staff to clarify.
	Contact Technical Colleges regarding their practice of waiting to release the Financial Aid Notification (FAN) until two weeks after the start of classes-Marian will draft a letter to the President of KCTCS under the Commissioner’s signature.
	Review guidelines on credentials/licensure of professionals from whom DVR purchases services-Sherri will ask Marian to review and then will discuss with Field Administrators and/or Senior Leadership Team.
	Correct glitches in Case Management System i.e. Cleft palate is termed harelip; case status reverts to "14" if no authorization is issued within the month-Don and Sherri will meet with Ralph and Mary Ann on issue.

Best Practices:

	Follow-up on diagnostic recommendations or document reasons for not following
	Consider use of Trial Work Experience instead of delaying the writing of IPE
	Follow-up with consumers in status "10"-do not accept an individual and leave them without contact
	Remember 12 month WORK expectancy for consumers with a life threatening illness
	Learning Disability and illiteracy are not the same thing
	You can certainly note and consider the consumer’s self-report of history, problems, impact of learning disability but self-report alone is not enough to establish this disability
	Expanded service on Eligibility Worksheet must be reflected on IPE
	Address limitations with services on IPE
	Give consumers options, choices, maximize potential but also use counselor judgment and counseling skills to assist the consumer in arriving at an INFORMED choice/decision
	Pull together information in case
	Guard against a single service-consumer only needs DVR monies not our expertise
	Receive grades prior to authorizing for continued training

 

How to Use as Field Leaders:

	Use form to review case but make both positive and constructive comments-don’t just circle yes or no without explanation
	Use comment sections on form to coach, relay your expertise, knowledge of resources not considered, etc.
	Cover this TRACKS summary in your next staff meeting
	Use this information when reviewing cases in the future
	Work one on one with counselors who are struggling, or who show trends or deficiencies in their casework
	Explain TRACKS process to staff and emphasize:

TRACKS does not talk about specific counselors, but instead TRACKS talks about ways to achieve consistent casework and to identify methods for provision of quality vocational services leading to the positive employment of Kentuckians with disabilities!!!!!!!!!

Continuous Improvement!!!!!

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